understand what the causes are and how to treat the problem

caused by bacteria mycobacterium leprae, also known as “leprosy” or “lazarus disease”, leprosy is an infectious and contagious disease that mainly affects the skin, nerves and eyes. According to data from the World Health Organization (WHO), between 2016 and 2020, around 155,300 cases of the disease were recorded in Brazil alone; of these, 19.9 thousand progressed to more serious situations.

Although the disease is part of the global health calendar, it is considered by the WHO as part of the group of Neglected Tropical Diseases (NTDs), that is, diseases with low indicators of investment in research and production of medicines. This, in turn, has influenced the difficulty of diagnosis and the chance of cure.

Ways of transmission of the disease

Despite the stigmas surrounding the disease indicating that it can be transmitted through direct contact with the skin, dermatologist Dr. Marina Righetto says that the disease can only be transmitted through direct contact with the bacteria mycobacterium leprae.

“The transmission of bacteria M. leprae via the respiratory route, through droplets of saliva or
nasal secretions and stems from a very close and prolonged coexistence with a patient
multibacillary without treatment, which is the transmitting form”, says the doctor.

Symptoms

Due to the fact that the bacillus that causes leprosy reproduces slowly, the initial symptoms of the disease can take from 6 months to 5 years to appear. According to the Ministry of Health, among the main indicators are:

• Light, dark or reddish spots on the skin;
• Absence of sensation in the hands, feet or face;
• Nodules (lumps) on the body (in some cases red and painful)
• Tingling;
• Numbness.

types of leprosy

According to the Madrid classification, the disease is divided into two groups: paucibacillary and multibacillary, which are subdivided into four classifications: indeterminate leprosy, tuberculoid, borderline and leprosy. As explained by Dr. Marina Righetto, initially, paucibacillary encompasses those with up to four lesions; in the multibacillary type, more than five lesions are manifested.

“Within the paucibacillary form, which is not a transmitting form of the disease, we subdivide it into:
indeterminate leprosy, which is the initial stage of illness and is characterized by the presence of up to five
ill-defined patches that do not show neural involvement, or in tuberculoid leprosy,
when the lesions become well defined and a nerve is compromised”, says the dermatologist.

As for the multibacillary type, the specialist says that the lesions are more expressive and difficult to identify between normal skin and damaged skin. “The multibacillary, the transmitting form of the disease, is subdivided into borderline or borderline, in which there are more than five lesions and involvement of two or more nerves. The Virchowian form is the most disseminated form of the disease, which presents classic characteristics resulting from progressive and diffuse infiltration of the skin. The patient sometimes acquires a ‘leonine’ aspect of the face”.

Diagnosis for disease

Diagnosing leprosy early is extremely important. For this purpose, there are clinical trials for assessing the patient’s ability to react to sensitivity, such as cold and heat, and for analyzing motor strength. After the clinical opinion, laboratory tests are performed to confirm the presence of the disease. Among them, there is biopsy and bacilloscopy, which identifies the presence of bacilli.

Treatment for leprosy

Although, in the past, the disease was a reason for isolation, it is currently curable, and treatment is offered free of charge by the Unified Health System (SUS). Combining three antimicrobial drugs, the method has proven to be effective in combating the problem. However, if not treated early, the disease can cause major consequences, such as physical limitations.

interference from drug association

According to the dermatologist, paying attention to medications taken without guidance during treatment is essential. “In case the patient makes use of other medications, these must be checked by their doctor to assess whether they present drug interaction with any of the three drugs used to treat the condition. For example, the use of ondansetron (Vonau), [o de] haloperidol and [o de] domperidone can interfere with clofazimine, one of the medications used in the treatment, increasing the risk of arrhythmias”, says the specialist.

Ways to prevent the condition

According to the Brazilian Society of Dermatology (SBD), adopting healthy lifestyle habits, such as practicing physical activity and eating right, is one of the most effective ways to prevent leprosy disease. It is also necessary to take the BCG vaccine, as this combination contributes to strengthening the immune system and prevents the body from becoming ill.